Fraud Auditor

Fraud Analyst Employment Type: Full Time Department: Litigation Support CGS seeks a Fraud Analyst to provide financial, forensic, and investigative support to government attorneys in the investigation and litigation of complex civil and criminal fraud matters. The Fraud Analyst will analyze financial and medical claims data, conduct forensic audits, develop damages assessments, and prepare reports and evidence to support investigations, prosecutions, settlements, and recoveries. The ideal candidate is a Certified Public Accountant (CPA) with auditing experience, expertise in financial analysis and fraud investigations, excellent communication skills, and the ability to handle sensitive and confidential information in a government environment. CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Skills and attributes for success: Assists the client in the investigation and trial preparation phases by conducting medical claims data analysis, forensic investigations, financial damages, statistical sampling, and ability-to-pay analyses, which serve a significant role in determinations regarding investigations, prosecutions, settlements, and recovery in these matters, which can be voluminous and complex. Investigations may well involve individually identifiable medical information, which the contractor will keep confidential, maintaining the privacy of the individuals who received the health care services or items. Confidentiality will also be maintained for matters under seal, such as qui tam lawsuits, and matters occurring before the grand jury. Investigations may concern sensitive matters, involve prominent individuals, organizations, or corporations within a client’s district, all of which the investigator will keep confidential. The Auditor shall perform comprehensive analytical, investigative, and financial examination duties in support of the client. Conduct audits in support of investigations and litigation involving the government's affirmative civil enforcement of federal laws, particularly the False Claims Act, 31 U.S.C. §§3729-3733, the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b)(1)(A), and the Stark Law, 42 U.S.C. § 1395nn(a) Conduct similar audits in support of criminal investigations involving 18 U.S. Code § 641, 18 U.S.C. 1343—Elements of Wire Fraud, 18 U.S.C. § 1341, 18 U.S.C. § 1347, 18 USC 1956: Laundering of monetary instruments, 18 U.S.C. § 1957. Reviewing, analyzing, and interpreting complex data sets, including Centers for Medicare & Medicaid Services claims data, PPP loan data, and records associated with health care fraud, defense procurement fraud, and other government program fraud. Identifying outlier billings and other anomalies within health care claim codes and normalizing claims data across multiple benefit plans to support time studies and other analytical assessments. Detecting trends, patterns, and relevant information within investigative and discovery records and applying this analysis to test data under various conditions. Reinterpreting and extrapolating results from Statistically Valid Random Samples when modifications to sample review outcomes occur. Developing, documenting, and defending loss calculation methodologies and financial damage models for litigation. Conducting financial investigations to assess the ability of individuals and organizations to satisfy settlements and judgments, including detailed analysis of assets, liabilities, debt covenants, borrowing capacity, earnings, financial ratios, aging schedules, tax considerations, and collectability. Examining personal…